. Physical diagnosis . me re-spects to that obtained bythe use of the free ear—that is, we are through itenabled to ascertain by lis-tening at one spot the con-dition of a much largerarea of the chest than canin any other way be inves-tigated. Owing to the fact thatboth cardiac and respiratorysounds are magnified by theBowles stethoscope, thisinstrument is especially welladapted for use with somesort of an attachment whereby several sets of ear pieces are sojoined by tubing to one chest piece that several persons may listenat once. Bowles multiple stethoscope, fitted for six and for twelveobse
. Physical diagnosis . me re-spects to that obtained bythe use of the free ear—that is, we are through itenabled to ascertain by lis-tening at one spot the con-dition of a much largerarea of the chest than canin any other way be inves-tigated. Owing to the fact thatboth cardiac and respiratorysounds are magnified by theBowles stethoscope, thisinstrument is especially welladapted for use with somesort of an attachment whereby several sets of ear pieces are sojoined by tubing to one chest piece that several persons may listenat once. Bowles multiple stethoscope, fitted for six and for twelveobservers, is seen in Figs. 88 and 89, and the method of its use in 1 It has frequently been observed, when listening with the ordinary stetho-scope, that a presystolic murmur can be better heard if only the very lightestpressure is made with the stethoscope. The fact that a thrill is communicatedto the chest wall, and that that thrill is connected with the audible murmurexplains my calling this murmur a superficial -Bowies Multiple Stethoscope for Six Stu-dents. AUSCULTATION. 143 Fig. 90. la the teaching of auscultation this instrument is of greatvalue, saving as it does the tune of the instructor and of the stu-dents and the strength of the patient. The sounds conductedthrough any one of the twelve tubes used in this instrument areas loud as those tobe heard with asingle instrument ofthe ordinary form,although far fainterthan those to beheard with a singleBowles stethoscope. II. The Use of theStethoscope. Having securedan instrumentwhich fits the earssatisfactorily, thebeginner may get agood deal of prac-tice by using it up-on himself, especi-ally upon his ownheart. The chiefpoint to be learned is to disregard various irrelevant sounds and toconcentrate attention upon those which ;gre relevant. Almost anyone hears enough with a stethoscope, and most beginners hear toomuch. No great keenness of hearing is required, for the soundswhich we listen for are not, as a rule, diff
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